Vitamin D and Immune System

Hamid Jan
Mohamed

B.

Nutrition Program
School of Health Sciences,
Universiti Sains Malaysia,
Kelantan, Malaysia

Jan

OUTLINE

Vitamin D
Immunity
Monsoon study- Vit. D
USM Pregnancy Cohort Study- Vit. D
Conclusions

What is Vitamin D
There are many vitamins needed by
our body to maintain health and
prevent disease.
Each vitamins has a specific role in
the body
Vitamin D is one of the important
vitamin.
One special character of vitamin D is
this is the only vitamin that can be
produced by our body.

Vitamin D Metabolism

UVB (290 315

nm)

[25(OH
)D]

Sources of Vitamin D

South East Asia Studies

Khor Geok Lin, 2014

Vitamin D and bone

health

Vitamin D - Iceberg
phenomena

[Thacher and Clarke, 2011]

Publication on Vitamin D

Vitamin D receptors
(Proteomics)

Vitamin D receptors in
immunity

Vitamin D and innate immunity

Adams JS and Hewison M (2008) Unexpected actions of vitamin D: new perspectives

on the regulation of innate and adaptive immunity
Nat Clin Pract Endocrinol Metab 4: 8090 doi:10.1038/ncpendmet0716

Endocrine, paracrine and intracrine

functions of Vitamin D

Vit D and immune System in

PubMed

The Universiti Sains Malaysia

Pregnancy Cohort Study

Objective
To investigate the effects of
vitamin D, prenatal
oxidative stress and
adipokines on the
development of maternalinfant adiposity.

Methodology

USM Birth Cohort Study: Conceptual

Framework
Oxidative Stress markers
Adipokine
Adipokine
s

- DNA damage, Malondialdehyde, Protein

carbonyl
- Adiponecti
- Total antioxidant capacity, enzymatic
n
15-22 &
antioxidant
Leptin
Blood
32-39
Nicotine
Prenatal
pressure
weeks of
exposure
Dietary
environm
Lipid
gestation

intake
Physical
activity
Anthropomet
ric
measuremen
ts
Infant
feeding

ent

Postnatal
environm
ent

Breast milk
adiponectin

metabolism
Glucose & insulin
levels
Pregnancy
symptoms
Child
care

Matern
alInfant
Adiposi
ty
At birth,
2, 6 &
12
months
3 years
&
5 years

Research Tools and Instruments

Body Composition Analyzer

(Tanita SC330-S, Illinois, USA)

Baby weighing scale

(Seca 334, Humburg, Germany)

Body meter scale

(Seca 206)

Measuring tape

Harpenden skinfold caliper

(British Indicator, UK)
Mini
electric
breast
pump
(Medela,
Illinous,
USA)

Serum 25-Hydroxyvitamin
D Measurement
Elecsys Vitamin D Total Assay

Cobas e 411, ECLIA

Good comparability to
reference method to
prove accuracy of
measurement
20

Objectives
To assess the adequacy of maternal
vitamin D status by measuring
maternal serum and breast milk 25hydroxyvitamin D [25(OH)D] levels.
To determine the association
between maternal serum and
breast milk 25(OH)D levels.

Methods
Sample size: 102 pregnant women, aged 19-40
years
25(OH)D analysis:
Blood samples were drawn at 18 & 34 weeks
gestation
Breast milk samples were collected at delivery, 2,
6 and 12 months postpartum were collected to
analyze for 25(OH)D levels
Performed by High Performance Liquid
Chromatography (HPLC)
Depending on maternal serum 25(OH)D levels,
the women were categorized as severe vitamin D
deficiency (<25 nmol/L), mild vitamin D
deficiency (25 to <50 nmol/L), vitamin D

Maternal 25(OH)D levels in the 2nd & 3rd

trimesters of pregnancy
p<0.001
58.99 nmol/l
(SD 20.43)
48.45 nmol/l
(SD 15.27)

Results

Associations between maternal factors

during pregnancy and serum 25(OH)D levels

Adjusted for maternal age and gestational age.

The 25(OH)D levels of breast milk

Associations between maternal serum and

breast milk 25(OH)D levels

Adjusted for maternal age and prenatal multivitamin intake

Discussion
Prevalence of vitamin D insufficiency
was high among the pregnant
women.
Serum vitamin D level during early
pregnancy is associated with the
breast milk vitamin D level at birth.

The Monsoon
Study

Objectives
To compare levels of vitamin D
1 between indoor and outdoor
workers in Kelantan

To compare levels of vitamin D during

monsoon and non-monsoon season
among indoor and outdoor workers in
Kelantan
31

Outdoor & Indoor Workers

Definition
Outdoor Workers

Fishermen

Group that receives regular and significant solar

ultraviolet rays (UVR) exposure [Gies et al., 1995]
Those reporting occupational sun exposures for
more than 2h/day between 0800 and 1400 h [Azizi
et al., 2009]

Indoor Workers

Office staff

Persons who are employed in nonindustrial,

nonagricultural indoor settings (indoor work
environments) [Mendell et al., 2002]
Stayed indoors more than half of their working time
[Chao and Wang, 1994]

32

Study design & setting

Kelantan

Funding:
Fundamental Research Grant
Scheme (MOHE)
Setting:
Wisma Persekutuan Kota Bharu
Kelantan Fishermen Villages
(Kota Bharu, Bachok & Semerak)
33

Flowchart
Comparative Point Prevalence Study
2nd Phase

1st Phase
Non-Northeast Monsoon
Season
(May June 2012)

Indoor Workers
(n=143)

Outdoor
Workers
(n=138)

Same
subjects
were
followed
up

Northeast Monsoon
Season
(Jan Feb 2013)

Indoor Workers
(n=121)

Outdoor
Workers
(n=118)

Data Collection

Data Collection

Analysis of Outcome

Analysis of Outcome
34

Vitamin D Concentrations between Non

Monsoon and Monsoon Season (WORKPLACE)

P<0.001

P<0.001

NS

35

Vitamin D Concentratios between Non

Monsoon and Monsoon Season (SEX)
Female
Male

P<0.001

P<0.001

n=10 n=127

n=8

n=110

Outdoor Workers

P<0.001

P<0.001

n=101 n=42

n=85

Indoor Workers
36

n=36

Conclusion

Vitamin D has important role in

immune systems which should be
explored among populations in
Asian region

Vitamin D deficiency is common

among indoor workers especially
females.

Thank you very

much

Correspondence

Mobile: 6012-6456477
Office: 609-7677618
Email: hamidjan@usm.my
Website: www.ppsk.usm.my